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Quantifying joint stiffness in clubfoot patients
M C van der Steen1, P A Andrei2, B van Rietbergen3
1Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, The Netherlands.
Clinical Biomechanics (Bristol, Avon)
|November 3, 2018
Summary
Clubfoot patients exhibit increased ankle and subtalar joint stiffness compared to healthy individuals. This objective measurement may help predict clubfoot relapses.
Area of Science:
- Orthopedics
- Biomechanical Engineering
- Pediatric Podiatry
Background:
- Clinical observation suggests a correlation between increased stiffness in clubfeet and a higher propensity for relapse.
- Objective quantification of clubfoot stiffness has been lacking, hindering clinical assessment and treatment monitoring.
- This study aimed to address this gap by objectively measuring ankle and subtalar joint stiffness in clubfeet.
Purpose of the Study:
- To objectively quantify ankle and subtalar joint stiffness in clubfoot patients.
- To compare joint stiffness between clubfeet and healthy controls.
- To introduce a novel measurement device for assessing clubfoot stiffness.
Main Methods:
- A newly developed Torque-Displacement-Handpiece integrated with an Abduction Dorsiflexion Mechanism (ADM) clubfoot-brace was utilized.
- The device allowed for controlled foot movement across two rotational axes while capturing torque and angulation data.
- Ankle and subtalar joint stiffness was assessed in 11 clubfoot patients (17 feet) and 11 healthy controls (22 feet).
Main Results:
- The Torque-Displacement-Handpiece provided reliable and precise measurements of torque, angulation, and stiffness.
- Clubfeet demonstrated significantly reduced angulation and increased stiffness across the ADM subtalar axis compared to controls.
- After adjusting for shoe size, clubfeet also exhibited significantly higher stiffness over the ADM tibiotalar axis.
Conclusions:
- Clubfoot patients present with objectively higher ankle and subtalar joint stiffness than healthy individuals.
- The developed measurement device offers a reliable method for assessing joint stiffness in clubfeet.
- This technology holds potential for monitoring clubfoot treatment and aiding in the early detection of relapses.
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